§ 125.2. Definitions.
The following words and terms, when used in this subchapter, have the following meanings, unless the context clearly indicates otherwise:
Act—The Workers’ Compensation Act (77 P. S. § § 1—1041.4, 2501—2506 and 2701—2708).
Active self-insurer—A self-insurer that is not a runoff self-insurer.
Actuary—A member in good standing of the Casualty Actuarial Society or a member in good standing of the American Academy of Actuaries.
Adequate accident and illness prevention program—A determination by the Bureau under Chapter 129 (relating to workers’ compensation health and safety) that a self-insured employer’s accident and illness prevention services fulfill the program and service requirements as stated in that chapter.
Affiliates—Employers which are closely related through common ownership or control.
Aggregate excess insurance—Insurance under which the insurer pays on behalf of or reimburses a self-insurer for its payment of benefits on claims incurred during a policy period in excess of the retention amount to the insurer’s liability limit.
Applicant—An employer requesting permission to initiate or to renew self-insurance, an employer requesting permission for it and its affiliates or subsidiaries to initiate or to renew self-insurance, or a parent company requesting permission for its subsidiaries to initiate or to renew self-insurance.
Authorized retention amount—A retention amount that is equal to or is less than a self-insurer’s maximum quick assets exposure amount or the current standard retention amount, whichever is less, or the special retention amount approved by the Bureau.
Bureau—The Bureau of Workers’ Compensation of the Department.
Cash flow protection amount—The maximum amount of benefits a self-insurer pays over a 2-year period on an occurrence without reimbursement from an insurer under a specific excess insurance policy with a per year per occurrence cash protection plan.
Catastrophic loss estimation—The greater of the following:(i) The largest number of employees anticipated to work at one time during a work day at the largest location in this Commonwealth in terms of the applicant’s employment, or the employment of any of its affiliates or subsidiaries under a consolidated permit under § 125.4 (relating to application for affiliates and subsidiaries), multiplied by the current Statewide average weekly wage multiplied by 500.
(ii) The current Statewide average weekly wage multiplied by 5,000.
Claims service company—An individual, corporation, partnership or association engaged in the business of servicing a self-insurer’s claims, including the adjusting and handling of claims, the payment of benefits and the provision of required reports.
Commonwealth—The term includes the following:(i) The government of the Commonwealth, including the following:
(A) The courts and other officers or agencies of the unified judicial system.
(B) The General Assembly, and its officers and agencies.
(C) The Governor, and the departments, boards, commissions, authorities and officers and agencies of the Commonwealth.
(ii) An employer, politic and corporate, exercising an essential government function under the laws of the Commonwealth that is not a political subdivision.
Dedicated asset account—An account or fund, such as a bank, checking or trust account or an internal services fund, holding cash or investments solely to finance or hold reserves for the payment of a public employer’s workers’ compensation liability and related expenses.
Department—The Department of Labor and Industry of the Commonwealth.
Employer—An employer as defined in section 103 of the act (77 P. S. § 21) or under section 103 of the Occupational Disease Act (77 P. S. § 1203), or both.
Excess indemnity insurance—Aggregate excess insurance or specific excess insurance that meets the requirements in § 125.11(b)(1) (relating to excess insurance).
Excess insurance—Excess indemnity insurance or workers’ compensation excess insurance.
Financial ability to self-insure—Possession of adequate financial capacity and adequate financial health, as specified in § 125.6(a) (relating to decision on application).
Guarantor—The affiliate or parent company that has guaranteed a self-insurer’s liability by executing an agreement under § 125.4(b) that is on file with the Bureau.
Investment grade long-term credit or debt rating—A long-term credit or debt rating identified as investment grade by the NRSRO that issued it.
Liability limit—The maximum amount of benefits for which an insurer indemnifies a self-insurer under an excess insurance policy.
Long-term credit or debt rating—A measurement by an NRSRO of an applicant’s willingness and intrinsic capacity to meet its long-term financial commitments as the commitments become due, exclusive of the effects of any guaranties, insurance or other forms of credit enhancements or legal priorities on any of the applicant’s financial obligations.
Loss development—The tendency of the cost of a group of claims to increase as they mature.
Maximum quick assets exposure amount—Five percent of an applicant’s average year-end quick assets amount for its last 2 completed fiscal years.
Minimum funding amount—The lower of the following:(i) The current Statewide average weekly wage multiplied by 500.
(ii) The retention amount of the applicant’s current or any proposed excess insurance, if applicable.
Minimum security amount—The lower of the following:(i) The current Statewide average weekly wage multiplied by 1,000.
(ii) The retention amount of the applicant’s current or any proposed excess insurance, if applicable.
NRSRO—A designated Nationally-recognized statistical rating organization of the United States Securities and Exchange Commission or its successor.
Occupational Disease Act—The Pennsylvania Occupational Disease Act (77 P. S. § § 1201—1603).
Parent company—An entity which directly or indirectly owns a majority of the voting stock of an employer or directly or indirectly controls a majority of the employer’s board of directors appointments if the employer has no voting stock.
Permit—The document issued by the Bureau to an employer which authorizes the employer to operate as a self-insurer.
Political subdivision—A county, city, borough, incorporated town, township, school district, vocational school district and county institution district, municipal authority, or other entity created by a political subdivision under law.
Private employer—An employer who is not a public employer as defined in this section.
Public employer—The Commonwealth or a political subdivision.
Quick assets—The sum of an applicant’s cash, cash equivalents, current receivables and marketable securities or, if the applicant is a public employer who uses fund accounting, the total of the applicant’s general fund assets.
Retention amount—(i) The maximum amount of benefits a self-insurer pays without reimbursement from the insurer under an aggregate excess insurance policy or under a specific excess insurance policy which does not include an annual cash flow protection plan.
(ii) The term also includes the lower of the maximum amount of benefits a self-insurer pays on each occurrence without reimbursement from the insurer or the cash flow protection amount under a specific excess insurance policy which includes an annual cash flow protection plan.
Runoff self-insurer—An employer that had been a self-insurer but no longer maintains a current permit.
Security—Surety bonds, letters of credit or cash or negotiable government securities held in trust to be used for the payment of a self-insurer’s workers’ compensation liability upon order of the Bureau if the self-insurer fails to pay its liability due to its financial inability or due to the self-insurer filing for bankruptcy or being declared bankrupt or insolvent.
Self-insurance—The privilege granted to an employer which has been exempted by the Bureau from insuring its liability under section 305(a) of the act (77 P. S. § 501(a)) and section 305 of the Occupational Disease Act (77 P. S. § 1405).
Self-insurance loss portfolio transfer policy—A policy of insurance accepted by the Bureau as meeting the requirements of § 125.21 (relating to self-insurance loss portfolio transfer policy) under which a self-insurer transfers liability incurred as a self-insurer to a workers’ compensation insurer.
Self-insurer—(i) An employer which has been granted the privilege to self-insure its liability and to maintain direct responsibility for the payment of this liability under the act and the Occupational Disease Act.
(ii) The term includes a parent company or affiliate which has assumed a subsidiary’s or an affiliate’s liability upon the termination of the parent-subsidiary or affiliate relationship.
Special retention amount—(i) A retention amount that exceeds the applicant’s maximum quick assets exposure amount or the standard retention amount requested by the applicant and approved by the Bureau based on a determination that the applicant has sufficient quick assets to easily liquidate all losses at the requested greater retention amount.
(ii) Additionally, an applicant whose self-insurance status began before September 11, 2010, may use a special retention amount that is equal to the retention amount of the applicant’s excess insurance in effect on September 11, 2010.
Specific excess insurance—Insurance under which the insurer pays on behalf of or reimburses a self-insurer for its payment of benefits on each occurrence in excess of the retention amount to the insurer’s liability limit.
Standard retention amount—(i) The current Statewide average weekly wage multiplied by 500.
(ii) Rounded upward to the nearest hundred thousand.
Statewide average weekly wage—The amount calculated and reported by the Bureau under section 105.1 of the act (77 P. S. § 25.1).
Subsidiary—An employer whose voting stock or board of directors appointments are directly or indirectly controlled by a parent company.
Workers’ compensation excess insurance—Aggregate excess insurance or specific excess insurance that meets the requirements in § 125.11(b)(2).
Workers’ compensation excess insurance recoveries—Payments made to a self-insurer under a policy of workers’ compensation excess insurance or payments receivable under a policy of workers’ compensation excess insurance that the insurer has agreed in writing that it is liable to pay.
Workers’ compensation insurer—An insurance company authorized to transact the class of insurance listed in section 202(c)(14) of The Insurance Company Law of 1921 (40 P. S. § 382(c)(14)).
Authority The provisions of this § 125.2 amended under sections 305(a) and 435(a) of the Workers’ Compensation Act (77 P. S. § § 501 and 991(a)) and section 2205 of The Administrative Code of 1929 (71 P. S. § 565).
Source The provisions of this § 125.2 amended October 23, 1998, effective October 24, 1998, apply to applicants, self-insurers, runoff self-insurers, group self-insurance funds and run-off funds, 28 Pa.B. 5459; amended September 10, 2010, effective September 11, 2010, 40 Pa.B. 5147. Immediately preceding text appears at serial pages (250120) to (250122).
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